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Klin Monbl Augenheilkd 2002; 219(9): 673-676
DOI: 10.1055/s-2002-35171
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© Georg Thieme Verlag Stuttgart · New York

Horner-Syndrom bei Karotisdissektion nach chiropraktischer Manipulation

Horner's Syndrome in Dissection of the Carotid Artery after Chiropractic ManipulationDaphne  Gamer1 , Andreas  Schuster1 , Klaus  Aicher2 , Eckart  Apfelstedt-Sylla1
  • 1Universitäts-Augenklinik Tübingen, Abteilung für Pathophysiologie des Sehens und Neuroophthalmologie (Ärztl. Dir.: Prof. Dr. E. Zrenner)
  • 2Radiologische Praxis Dr. Aicher, Dr. Majer, Dr. Kölbel, Tübingen
Further Information

Publication History

Eingegangen: 23. Juli 2002

Angenommen: 5. September 2002

Publication Date:
30 October 2002 (online)

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Zusammenfassung

Fallbericht: Wir berichten über einen 37-jährigen Patienten, der etwa fünf Wochen nach einer chiropraktischen Manipulation an der Halswirbelsäule über plötzliche Schmerzen der Kopfhaut rechts sowie eine engere Pupille auf derselben Seite klagte. Methoden/Ergebnisse: Durch pharmakologische Testung der Pupillen wurde ein postganglionäres Horner-Syndrom rechts nachgewiesen, das kernspintomographisch auf eine ipsilaterale Karotisdissektion im subakuten Stadium zurückgeführt werden konnte. Schlussfolgerung: Der vorliegende Fall legt einen ursächlichen Zusammenhang von Karotisdissektion und chiropraktischer Manipulation der Halswirbelsäule nahe. Dem Augenbefund kam die entscheidende Bedeutung bei der Erkennung dieser Behandlungskomplikation zu.

Abstract

Case report: We report on a 37-year old patient with sudden onset of pain of the right scalp and an ipsilateral small pupil, presenting five weeks after chiropractic manipulation of the neck. Methods/Results: Pharmacologic pupil testing showed a postganglionic Horner's syndrome on the right side. Magnetic resonance angiography confirmed the diagnosis of a dissection of the right internal carotid artery at a subacute stage. Conclusion: There appears to be a causal relationship between carotid artery dissection and the chiropractic manipulation of the cervical spine. Ophthalmological signs played the key role in detecting this complication.

Schlüsselwörter

Horner-Syndrom - Karotisdissektion - chiropraktische Manipulation

Key words

Horner's syndrome - dissection of the carotid artery - chiropractic manipulation

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Dr. med. Daphne Gamer

Universitäts-Augenklinik Tübingen · Abteilung für Pathophysiologie des Sehens und Neuroophthalmologie

Schleichstraße 12

72076 Tübingen

Email: daphne.gamer@med.uni-tuebingen.de